Compliance & Audit
Audits are on the rise – but that doesn’t have to mean more stress! Fieldworker keeps your agency audit-ready
There are many requirements each care agency needs to fulfill in order to ensure audits run smoothly. That’s why it’s essential they have access to a platform that helps them keep up with ever-evolving guidelines and keep them audit-ready at all times.
FieldWorker is designed by experts in technology and care delivery, who have ensured that there’s a place for all of your records on the platform. Whether you need EVV records, timesheets or overviews of billing and expenses, everything is kept in one accessible place.
Support Coordination Agencies
The Rationale for Support Coordination Agency Evaluation
Ensure high-quality services are being provided to individuals served.
Ensure that SCAs meet Division waiver (manual) requirements.
Ensure that SCAs are meeting the requirements necessary for claiming/avoiding Medicaid fraud.
Centers for Medicare and Medicaid Services (CMS) reserves the right to audit waiver programs.
Recent audit findings
In 23% of audited cases, central registry checks were not completed
In 36% of cases, DDD-required training was missing
In 21% of cases, no updates were being made to PCPT
In 10% of the cases, quarterly MMT was missing
In 12% of cases, annual home visit documentation was missing
An SCA must provide services in at least one county and for a minimum of 60 individuals. While a deadline is not yet established, any Support Coordination Agency that serves below 60 individuals is directed to take steps to meet that minimum requirement.
Ensuring compliance
Services billed matched with a qualifying task in the system
Services billed are matched and documented with qualified staff and the correct date of service.
No duplicate billing, No missing records
Ensuring that a signature is captured, where needed
No missing documentation
Exclusions Program
OIG has the authority to exclude individuals and entities from Federally funded health care programs.
This webpage provides information about OIG's exclusion authority and activities. OIG has the authority to exclude individuals and entities from Federally funded healthcare programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud. Those that are excluded can receive no payment from Federal health care programs for any items or services they furnish, order, or prescribe. This includes those that provide health benefits funded directly or indirectly by the United States (other than the Federal Employees Health Benefits Plan).
OIG maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE). Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties (CMP). To avoid CMP liability, healthcare entities should routinely check the list to ensure that new hires and current employees are not on it.
Debarment Report
Comparison Logic: Employee First Name, Last Name, and Employee ZIP
NJ Treasury
NJ Consolidated Debarment Report
Comparison Logic: Employee First Name, Last Name, and Employee ZIP
For support coordination agencies, Fieldworker allows you to generate a debarment report, on demand.
Last updated
Was this helpful?
